Performance of EasyBreath® Decathlon Snorkeling mask for Delivering Continuous Positive Airway Pressure

ABSTRACT Background During the COVID-19 pandemic, the need for noninvasive respiratory support devices has dramatically increased, sometimes exceeding hospital capacity. The full-face Decathlon snorkeling mask, EasyBreath ® (EB ® mask), has been adapted to deliver continuous positive airway pressure (CPAP) as an emergency respiratory interface. We aimed to assess the performance of this modified EB ® mask. Methods CPAP set at 5, 10, and 15 cmH 2 O was delivered to 10 healthy volunteers with a high-flow system generator set at 40, 80, and 120 L min -1 and with a turbine-driven ventilator during both spontaneous and loaded (resistor) breathing. Inspiratory CO 2 partial pressure (PiCO 2 ), pressure inside the mask, breathing pattern and electrical activity of the diaphragm (EAdi) were measured at all combinations of CPAP/flows delivered, with and without the resistor. Results Using the high-flow generator set at 40 L min -1 , the PiCO 2 significantly increased and the system was unable to maintain the target CPAP of 10 and 15 cmH 2 O and a stable pressure within the respiratory cycle; conversely, the turbine-driven ventilator did. EAdi significantly increased with flow rates of 40 and 80 L min -1 but not at 120 L min -1 and with the turbine-driven ventilator. Conclusions EB ® mask can be safely used to deliver CPAP only under strict constraints, using either a high-flow generator at a flow rate greater than 80 L min -1 , or a high-performance turbine-driven ventilator.